Marian Bátovský
The goals of managing the patient with gastrointestinal bleeding are similar in variceal and non variceal bleeding from upper gastrointestinal tract and also from lower part of this tract. First, the patient´s hemodynamic status must be rapidly assessed and resuscitative measures initiated if necessary. Only then should the next steps in management be undertaken: determine the source of the haemorrhage, stop the bleeding, and prevent recurrent bleeding. The means of accomplishing of these goals have changed dramatically. Early endoscopy is important to identify the source of bleeding and endoscopic therapy at this time has also been shown to decrease further bleeding. The bleeding patients clearly benefit from endoscopic haemostatic therapy. Various endoscopic mechanic and thermal method of haemostasis have been evaluated since 1980 - injection of epinephrine, sclerosing agents, clips, laser, bipolar coagulation, heater probe and others.